Gastric lavage cost-effective way of diagnosing TB in remote areas

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"The cornerstone of TB diagnosis is the examination of the patient's sputum for three days. However, in remote areas for example, where bronchoscopy facilities are not available, gastric lavage - that is washing of the stomach - is a cost-effective way of diagnosing TB." This was stated by Dr. Muhammad Irfan, Consultant Pulmonologist and Assistant Professor, Section of Pulmonary and Critical Care Medicine at Aga Khan University Hospital (AKUH) at a recently held programme to commemorate World TB Day. Dr Irfan was discussing current TB diagnostic methods in his presentation, and the programme, which was held at Aga Khan University (AKU), was jointly organised by his Section in conjunction with AKU's Office of Continuing Medical Education (CME).

Dr. Nisar Ahmed Rao, Assistant Professor at the Ojha Institute of Chest Diseases said that MDR (Multiple Drug Resistant) TB is on the rise, and the World Health Organization (WHO) estimates the prevalence of MDR TB in Pakistan as 9.6 per cent. He further highlighted the startling figures of 3 million deaths worldwide die each year due to TB. Dr Rao also brought to light WHO's recently-introduced concept, "XDR (Extensive Drug Resistant) TB" and accordingly cautioned that General Practitioners should not try to treat such resistant TB but refer such cases to chest specialist or chest hospitals. He stressed that for proper control of TB, over-the-counter sales of anti-TB drugs should be banned.

Dr. Anita Zaidi, Consultant Paediatrician and Associate Professor Department of Paediatrics at AKUH revealed that malnourished children of less than 4 years age are more prone to develop TB and pointed out in children symptoms are non-specific such as fever, failure to thrive, or weight loss.

Dr. Nadeem Rizvi, Head of the Department of Thoracic Medicine at the Jinnah Postgraduate Medical Centre, advised doctors that they should, at the start of treatment, explain to patients the nature of the disease, the duration of its treatment, and possible side effects. Further, patients should not modify the regimen and must inform the treating doctor of any problems with the medication. Dr Rizvi illustrated to the attending doctors the means of managing common issues arising during treatment.

Dr. Waseem Memon, Consultant Radiology and Assistant Professor of Radiology at AKUH, discussed the various radiological presentations of pulmonary tuberculosis. He said that Chest X-rays should not be totally relied upon for diagnosis of TB but should be further verified by sputum results.

For the benefit of community physicians, AKU regularly organises Continued Medical Education seminars and workshops. These programmes are design ed to provide current, practical update on the management of medical problems faced by primary care physicians and specialists.

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